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<html xmlns="http://www.w3.org/1999/xhtml" xml:lang="en" lang="en">

<head>
	<title>sem título</title>
	<meta http-equiv="content-type" content="text/html;charset=utf-8" />
        <script  type="text/javascript" src="js/script.js"></script>
        <link type="text/css" rel="stylesheet" href="css/style.css"/>
</head>

<body>
	
	<div id="content">
            <h1>Informações do Paciente</h1>
            
            <div id="menu">
                <ul>
                    <li><a href="homeMedico.html"> Página Inicial</a></li>
                    <li><a href="addProntuario.html"> Prontuário</a></li>                                     
                </ul>
            </div>
                 
		<form name="infoPaciente" id="infoPaciente" method="post" action="#">
            <div id="erro"></div>
			<fieldset>
				<legend>Busque Paciente</legend>
				<table>
					<tr>
						<td colspan="4">
							<div id="buscaPaciente">
								<label for="inpBuscaPaciente">Paciente:
									<input id="inpBuscaPaciente" type="text" name="buscaPaciente" onblur="return validate(this,validStringAlpha,'Paciente');"/>
								</label>
							</div>
						</td>
					</tr>
				</table>
			</fieldset>
			<fieldset>
				<legend>Informações Cotidiano</legend>
				<table>
					<tr>
						<td style="width: 100px;">Fuma:</td>
						<td>
							<input type="radio" name="fuma" value="sim"/> SIM
							<input type="radio" name="fuma" value="nao"/> NÃO
							<input type="radio" name="fuma" value="asvezes"/> As Vezes
						</td>						
					</tr>
					<tr>
						<td >Bebe:</td>
						<td>
							<input type="radio" name="fuma" value="sim"/> SIM
							<input type="radio" name="fuma" value="nao"/> NÃO
							<input type="radio" name="fuma" value="socialmente"/> Socialmente
						</td>
					</tr>					
				</table>
			</fieldset>	
			<fieldset>
				<legend>Informações doenças</legend>
				<table>
					<tr>
						<td style="width: 150px;">Diabete:</td>
						<td>
							<input type="radio" name="diabete" value="sim"/> SIM
							<input type="radio" name="diabete" value="nao"/> NÃO
						</td>
					</tr>
					<tr>
						<td>Colesterol:</td>
						<td>
							<input type="radio" name="colesterol" value="sim"/> SIM
							<input type="radio" name="colesterol" value="nao"/> NÃO
						</td>
					</tr>
					<tr>
						<td>Doenças Cardíacas:</td>
						<td colspan="3">
							<input type="radio" name="doenCard" value="sim"/> SIM
							<input type="radio" name="doenCard" value="nao"/> NÃO
						</td>
					</tr>
				</table>
			</fieldset>	
			<fieldset>
				<legend>Cirurgias</legend>
				<table>
					<tr>
						<td><input type="text" name="cirurgia1"/></td>
					</tr>
					<tr>
						<td><input type="text" name="cirurgia2"/></td>
					</tr>
					<tr>
						<td><input type="text" name="cirurgia3"/></td>
					</tr>
					<tr>
						<td><input type="text" name="cirurgia4"/></td>
					</tr>
					<tr>
						<td><input type="text" name="cirurgia5"/></td>
					</tr>
				</table>
			</fieldset>	
			<fieldset>
				<legend>Alergias</legend>
				<table>
					<tr>
						<td><input type="text" name="alergia1"/></td>
					</tr>
					<tr>
						<td><input type="text" name="alergia2"/></td>
					</tr>
					<tr>
						<td><input type="text" name="alergia3"/></td>
					</tr>
					<tr>
						<td><input type="text" name="alergia4"/></td>
					</tr>
					<tr>
						<td><input type="text" name="alergia5"/></td>
					</tr>
				</table>
			</fieldset>
                        
                        <input type="reset" value="Cancelar"/>
                        <input type="submit" value="Salvar"/>
		</form>
	</div>
</body>

</html>
